Abstract Air pollution consists of a heterogeneous mixture of gasses and particles that include carbon monoxide, nitrates, sulfur dioxide, ozone, lead, toxic by-product of tobacco smoke and ...particulate matter. Oxidative stress and inflammation induced by inhaled pollutants may result in acute and chronic disorders in the respiratory system, as well as contribute to a state of systemic inflammation and autoimmunity. This paper reviews the mechanisms of air contaminants influencing the immune response and autoimmunity, and it focuses on studies of inhaled pollutants triggering and/or exacerbating rheumatic diseases in cities around the world. Remarkably, environmental factors contribute to the onset of autoimmune diseases, especially smoking and occupational exposure to silica in rheumatoid arthritis and systemic lupus erythematosus. Other diseases such as scleroderma may be triggered by the inhalation of chemical solvents, herbicides and silica. Likewise, primary vasculitis associated with anti-neutrophil cytoplasmic antibody (ANCA) may be triggered by silica exposure. Only few studies showed that air pollutants could trigger or exacerbate juvenile idiopathic arthritis and systemic lupus erythematosus. In contrast, no studies of tropospheric pollution triggering inflammatory myopathies and spondyloarthropathies were carried out. In conclusion, air pollution is one of the environmental factors involved in systemic inflammation and autoimmunity. Further studies are needed in order to evaluate air pollutants and their potentially serious effects on autoimmune rheumatic diseases and the mechanisms involved in the onset and the exacerbation of these diseases.
Objective
To investigate the association between exposure to air pollutants in the Sao Paulo metropolitan area and disease activity in juvenile‐onset systemic lupus erythematosus (SLE) patients.
...Methods
A longitudinal panel study based on 409 consecutive visits of juvenile‐onset SLE patients living in the Sao Paulo metropolitan area was carried out. Disease activity was evaluated in accordance with the Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI‐2K), and the patients were divided into 2 groups: those with SLEDAI scores ≤8 and those with SLEDAI scores >8. Daily concentrations of inhaled particulate matter (PM10), sulfur dioxide, nitrogen dioxide (NO2), ozone, and carbon monoxide (CO) were evaluated on the 21 days preceding the medical visits. A generalized estimation equation model was used to assess the impact of these measurements on SLEDAI‐2K scores, considering the fixed effects for repetitive measurements. The models were adjusted for erythrocyte sedimentation rate, corticosteroid use (daily and cumulative doses), antimalarial use, the use of immunosuppressive agents, the presence of infection 20 days preceding the medical appointment, and the minimum temperature and relative humidity outdoors.
Results
PM10, NO2, and CO were risk factors for juvenile‐onset SLE disease activity (SLEDAI‐2K score >8) approximately 2 weeks after exposure. A 13.4 μg/m3 increase in the PM10 moving average (from lag 12 to lag 15) was associated with a 34% increase (95% confidence interval 7.0–68.0) in the risk of a SLEDAI‐2K score >8.
Conclusion
This is the first study to show that exposure to inhaled pollutants may increase the risk of disease activity in children with juvenile‐onset SLE in a large urban center.
The electrocatalytic oxidation of small organic molecules is of general importance for energy-related issues such as the fuel cells and electrochemical re-formation. The common emergence of ...current/potential oscillations in these reactions has implications on mechanistic aspects as well as on the overall conversion, and thus on the performance of practical devices. We investigate in this paper some general features of the electro-oxidation of formaldehyde, formic acid, methanol, and ethanol on platinum and in acidic media, with emphasis on the comparison of the activity under conventional and oscillatory regimes. The comparison is carried out by different means and generalized by the use of identical experimental conditions in all cases. In all four systems studied, the occurrence of potential oscillations is associated with excursions of the electrode potentials to lower values, which noticeably decreases the overpotential of the anodic reaction, when compared to that in the absence of oscillations. Quantitatively speaking, a 2-fold enhancement in the power density was observed in an idealized fuel cell operated with formaldehyde. This aspect, together with spontaneous self-cleaning processes, presents important advantages to the use of autonomous oscillations to reach both higher and long-term activities. Finally, some mechanistic aspects of the studied reactions are also discussed.
Objective
To evaluate the influence of exposure to inhaled environmental factors during pregnancy on the diagnosis of juvenile dermatomyositis (DM).
Methods
We performed a case–control study ...comprising 20 juvenile DM patients and 56 healthy controls matched by age and sex who were residents in the metropolitan region of a large city. A questionnaire assessed demographic data and environmental inhalation exposure during pregnancy (occupational exposure to demolition, chalk, construction and/or quarry dust, paints, varnish, gasoline vapor, and/or battery fluids; stationary sources of inhaled pollution near the mother's home; and maternal tobacco exposure). Daily concentrations of inhaled particulate matter, SO2, NO2, O3, and carbon monoxide (CO) were evaluated throughout the gestational period.
Results
Maternal occupational exposure to school chalk dust/gasoline vapor in the juvenile DM group was significantly higher compared with controls (50% versus 4.6%; P = 0.001). Smoking mothers and secondhand smoke exposure at home during pregnancy were significantly higher in the juvenile DM group versus controls (smoking mothers: 20% versus 1.7%; P = 0.01, and secondhand smoke: 35% versus 19%; P = 0.07). In univariate logistic regression models, maternal smoking, occupational exposure to inhaled agents, and the highest tertile of tropospheric CO (3.2–5.4 parts per million) in the third trimester were significantly associated with juvenile DM (P ≤ 0.05). In the multivariate analysis, smoking mother (odds ratio OR 13.26 95% confidence interval (95% CI) 1.21–144.29, P = 0.03), occupational exposure (OR 35.39 95% CI 1.97–632.80, P = 0.01), and CO (third tertile) exposure in the third trimester of gestation (OR 12.21 95% CI 1.28–115.96, P = 0.03) remained risk factors for juvenile DM.
Conclusion
Inhaled pollutants and tobacco smoking during fetal development may contribute to juvenile DM.
Objective: The objective of this study is to evaluate the influence of exposure to air pollutants and inhalable environmental elements during pregnancy and after birth until childhood-onset systemic ...lupus erythematosus(cSLE) diagnosis.
Methods: This case-control study comprised 30 cSLE patients and 86 healthy controls living in the Sao Paulo metropolitan area. A structured and reliable questionnaire (kappa index for test-retest was 0.78) assessed demographic data, gestational and perinatal-related-factors, and exposure to inhalable elements during pregnancy and after birth (occupational exposure to inhalable particles and/or volatile vapor, and/or tobacco, as well as, the presence of industrial activities or gas stations near the home/work/daycare/school). Tropospheric pollutants included: particulate matter (PM
10
), sulfur dioxide (SO
2
), nitrogen dioxide (NO
2
), ozone (O
3
) and carbon monoxide (CO).
Results: The median current age was similar between cSLE patients and healthy controls 16.0 (5-21) versus 15.0 (4-21) years, p = .32, likewise the frequency of female gender (87% versus 78%, p = .43). The frequencies of prematurity (30% versus 6%, p = .001), maternal occupational exposure during pregnancy (59% versus 12%, p < .001), exposure to volatile vapor (48% versus 8%, p < .001) and fetal smoking (maternal and/or secondhand) (37% versus 19%, p = .008) were significantly higher in cSLE patients compared with controls. In a multivariate analysis regarding the gestation period, maternal occupational exposure (OR 13.5, 95% CI 2.5-72.4, p = .002), fetal smoking (OR 8.6, 95%CI 1.6-47, p = .013) and prematurity (OR 15.8, 95%CI 1.9-135.3, p = .012) remained risk factors for cSLE development. Furthermore, exposure to secondhand smoking during pregnancy and after birth (OR 9.1, 95%CI 1.8-42.1, p = .002) was also a risk factor for cSLE development.
Conclusions: Prematurity and environmental factors were risk factors for developing cSLE.
Objective: To investigate the lag structure effects from exposure to atmospheric pollution in acute outbursts in hospital admissions of paediatric rheumatic diseases (PRDs). Methods: Morbidity data ...were obtained from the Brazilian Hospital Information System in seven consecutive years, including admissions due to seven PRDs (juvenile idiopathic arthritis, systemic lupus erythematosus, dermatomyositis, Henoch–Schönlein purpura, polyarteritis nodosa, systemic sclerosis and ankylosing spondylitis). Cases with secondary diagnosis of respiratory diseases were excluded. Daily concentrations of inhaled particulate matter (PM10), sulphur dioxide (SO2) nitrogen dioxide (NO2), ozone (O3) and carbon monoxide (CO) were evaluated. Generalized linear Poisson regression models controlling for short-term trend, seasonality, holidays, temperature and humidity were used. Lag structures and magnitude of air pollutants’ effects were adopted to estimate restricted polynomial distributed lag models. Results: The total number of admissions due to acute outbursts PRD was 1,821. The SO2 interquartile range (7.79 µg/m3) was associated with an increase of 1.98% (confidence interval 0.25–3.69) in the number of hospital admissions due to outcome studied after 14 days of exposure. This effect was maintained until day 17. Of note, the other pollutants, with the exception of O3, showed an increase in the number of hospital admissions from the second week. Conclusion: This study is the first to demonstrate a delayed association between SO2 and PRD outburst, suggesting that oxidative stress reaction could trigger the inflammation of these diseases.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, OILJ, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
In order to determine the susceptibility and serum neutralizing antibody response of Desmodus rotundus to rabies virus, bats were inoculated with a virus isolated from a naturally infected ...haematophagous bat. Bats were divided into four groups of 10 animals each. Dilutions of rabies virus containing 100, 1000, 10000 and 100000 MICLD50 (lethal dose 50% for mice inoculated by the intracerebral route) were administrated in the pectoral muscle. The presence of rabies virus was detected in brain and salivary glands by fluorescent antibody, mouse inoculation and RT–PCR. The observed mortality for each virus dose was 0, 20, 20 and 60% respectively. Serum neutralizing antibodies were tested for by the rapid fluorescent focus inhibition test, and antibody titres greater than 0·5 IU/ml were found in 53% of bats 30 days after virus inoculation. Resistance to infection was seen in bats that developed low or no detectable antibody response as well as in bats with high titres. Among the 10 bats that died of rabies, eight showed signs of paralytic rabies and two bats showed no clinical signs.
Blindness caused by severe vasculitis or uveitis is rare in juvenile systemic lupus erythematosus (JSLE) patients. In a 27-year period, 5367 patients were followed at our Paediatric Rheumatology ...Division and 263 (4.9%) patients had JSLE (American College of Rheumatology criteria). Of note, two (0.8%) of them had irreversible blindness. One of them presented with cutaneous vasculitis and malar rash, associated with pain and redness in both eyes, impairment of visual acuity due to iridocyclitis and severe retinal vasculitis with haemorrhage. Another patient had peripheral polyneuropathy of the four limbs and received immunosuppressive drugs. Three weeks later, she developed diffuse herpes zoster associated with acute blindness due to bilateral retinal necrotizing vasculitis compatible with varicella zoster virus ocular infection. Despite prompt treatment, both patients suffered rapid irreversible blindness. In conclusion, irreversible blindness due to retinal vasculitis and/or uveitis is a rare and severe lupus manifestation, particularly associated with disease activity and viral infection.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, OILJ, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
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